Currently submitted to: Journal of Medical Internet Research
Date Submitted: Jul 4, 2019
(closed for review but you can still tweet)
Medication management apps for diabetes: A systematic assessment of the transparency and reliability of health information dissemination
Smartphone apps are increasingly used for disease management but the transparency and reliability of information sources for these apps are unclear.
As part of a larger study investigating medication management features of diabetes apps, this study aimed to assess the transparency and reliability of information disseminated via these apps against eight criteria adapted from the Health On the Net (HONcode) principles.
English language diabetes-related terms were searched on a market explorer (42matters) on 12 June 2018. Apps with both medication and blood glucose management features were downloaded and evaluated against the app-HONcode criteria adapted from the eight HONcode principles: Authoritative, Complementarity, Privacy, Attribution, Justifiability, Transparency, Financial disclosure, and Advertising policy. Apps were profiled by operating platforms (i.e. Android, iOS) and number of downloads (i.e. Android only: >100,000 downloads, <100,000 downloads).
143 apps (81 Android, 62 iOS) were downloaded and assessed against the adapted App-HONcode criteria. Most of the apps on both the Android and iOS platforms fulfilled between two to six criteria but very few apps mentioned the qualifications of individuals who contributed to app development (14.0%, 20/143). A higher proportion of iOS apps fulfilled six or more App-HONcode criteria compared with Android apps. However, Android apps were more likely to have the developer’s email listed on the apps store (Android: 97.6%, 75/81, iOS: 83.9%, 52/62, P=.005) compared with iOS apps. Of the Android apps assessed, a significantly higher proportion of highly downloaded apps had a privacy and confidentiality clause (High downloads: 88.2%, 15/17; Lower downloads DL: 51.6%, 33/64; P=.006) and were more likely to discuss their financial sources (High downloads: 82.4%, 14/17; Lower downloads: 50.0%, 32/64; P =.026) compared with apps with lower downloads.
Gaps in the disclosure of the developer’s qualification, funding source and the complementary role of the app in disease management were identified, which can be resolved with stricter pre-requisites set by the app stores. Future work can further examine the consent seeking process for data collection, data management policies, and the appropriateness of advertising content and clarity of privacy clause of these apps.